Summary of Responses: Video Evidence for Medicare Appeals
William Lifford, CP
Description
Collection
Title:
Summary of Responses: Video Evidence for Medicare Appeals
Creator:
William Lifford, CP
Date:
4/4/2013
Text:
Hello Colleagues,
I called Administrative Law Judge Catherine Fuller's office, and they
consulted with their technical support staff. They said the tech guys
told them to make sure the video clips will be playable on Windows Media
Player, and they can be sent either on a Flash drive or CD-ROM.
As for the responses, here they are:
1. I've heard of using a private Youtube channel for submitting video
evidence.
Please post responses.
2. If video evidence was submitted to C2C then it automatically goes to
the ALJ. We are having problems w C2C ignoring clear concise
documentation that should get a claim paid. It's a pain but meet w your
Congressman. This is not going away for a long time.
3. I resend everything everytime. I don't care if they tell me that I
don't need to resend what I sent at redetermination or reconsideration.
I never trust that everything I sent is actually scanned in and
accessible by the next level of appeal. So I resend it all. I don't
care if they are overloaded by paperwork. I am overloaded by paperwork
due to the ridiculousness of these denials.
4. Are you willing to base your appeal on the information forwarded
by those denying your claim? By conveniently losing some of the
information you submitted they put your claim in jeopardy. You should
send all the information previously submitted, in addition to follow-up
arguments and additional information based on what you may have gleaned
from the denial. Make sure to point out the ignoring of evidence you
submitted, and lastly ask for interest on the amount incorrectly denied.
5. This is exactly what C2C did with every single one of my audits.
They would exclude certain documentation, then deny the appeal based on
this missing documentation. I filed two complaints with the Small
Business Association because of it
And filed a complaint with the medical licensing board against the
physician at C2C that was doing this to my appeals.
Yes, you will have to re-send it to the ALJ. Be sure to explain it to
them that C2C voluntarily eliminated your documentation to justify a
denial.
6. We submitted a QR link to a video and Medicare said that they
wanted a CD. We sent it but haven't heard back yet.
7. I was contacted with good information and sound advice regarding the
videos. Make sure you get an appropriate signed release and any other
legal documents that are required, prior to posting video's anywhere on
a publicly accessed site. This is an issue where HIPPA will certainly be
involved, so don't underestimate this process.
--
William Lifford, CP
Progressive O&P, Inc.
1111 Willis Avenue
Albertson, NY 11507
516-338-8585
www.ProgOandP.com
I called Administrative Law Judge Catherine Fuller's office, and they
consulted with their technical support staff. They said the tech guys
told them to make sure the video clips will be playable on Windows Media
Player, and they can be sent either on a Flash drive or CD-ROM.
As for the responses, here they are:
1. I've heard of using a private Youtube channel for submitting video
evidence.
Please post responses.
2. If video evidence was submitted to C2C then it automatically goes to
the ALJ. We are having problems w C2C ignoring clear concise
documentation that should get a claim paid. It's a pain but meet w your
Congressman. This is not going away for a long time.
3. I resend everything everytime. I don't care if they tell me that I
don't need to resend what I sent at redetermination or reconsideration.
I never trust that everything I sent is actually scanned in and
accessible by the next level of appeal. So I resend it all. I don't
care if they are overloaded by paperwork. I am overloaded by paperwork
due to the ridiculousness of these denials.
4. Are you willing to base your appeal on the information forwarded
by those denying your claim? By conveniently losing some of the
information you submitted they put your claim in jeopardy. You should
send all the information previously submitted, in addition to follow-up
arguments and additional information based on what you may have gleaned
from the denial. Make sure to point out the ignoring of evidence you
submitted, and lastly ask for interest on the amount incorrectly denied.
5. This is exactly what C2C did with every single one of my audits.
They would exclude certain documentation, then deny the appeal based on
this missing documentation. I filed two complaints with the Small
Business Association because of it
And filed a complaint with the medical licensing board against the
physician at C2C that was doing this to my appeals.
Yes, you will have to re-send it to the ALJ. Be sure to explain it to
them that C2C voluntarily eliminated your documentation to justify a
denial.
6. We submitted a QR link to a video and Medicare said that they
wanted a CD. We sent it but haven't heard back yet.
7. I was contacted with good information and sound advice regarding the
videos. Make sure you get an appropriate signed release and any other
legal documents that are required, prior to posting video's anywhere on
a publicly accessed site. This is an issue where HIPPA will certainly be
involved, so don't underestimate this process.
--
William Lifford, CP
Progressive O&P, Inc.
1111 Willis Avenue
Albertson, NY 11507
516-338-8585
www.ProgOandP.com
Citation
William Lifford, CP, “Summary of Responses: Video Evidence for Medicare Appeals,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/235046.
